This inspection was announced and took place on 20, 21 and 22 November 2017. Helping Angels Ltd is registered to provide personal care support to people living in their own homes in the community. People who used the service had physical health needs (some of whom were living with dementia), and younger adults and children with disabilities. At the time of our inspection, 102 people were receiving personal care support. This announced inspection was carried out by one inspector and an expert by experience. The expert by experience had knowledge of care services including domiciliary services.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection on 21 November 2016, we asked the provider to take action to ensure they were following guidance when people were not able to make decisions about their care. They sent us an action plan on 4 April 2017, and at this inspection, we found the action had been completed. At the last inspection, the service received an overall rating of ‘requires improvement.’ At this inspection, the provider had made the improvements needed, and is now rated overall as ‘good.’

People were safe receiving support from staff who understood how to protect them from abuse. Risks to individuals were managed and staff knew how to reduce the risk of harm. There were enough staff to meet people’s needs and keep them safe, and people were supported by a regular team of staff. The provider followed safe recruitment practices to ensure staff were suitable to work with people. When people needed support with the medicines, this was done safely. People who used the service and staff were protected by the prevention and control of infection. The provider took action and made improvements when practice issues were identified.

The provider followed guidance when people were not able to make decisions about the care they received. Staff understood how to put this guidance into practice. People were supported to have maximum choice and control of their lives. When able to, people had consented to receiving care and staff gained their agreement prior to assisting them. People’s needs were assessed and their support was delivered in line with current guidance. Staff had the skills and knowledge to provide effective care to people. People were supported to maintain a balanced diet and access healthcare services when needed. The provider worked with other organisations to enable people to receive co-ordinated care and support.

People were treated with kindness, and staff knew people and their families well. Staff were able to communicate well with people, and understood how to do this if people did not use spoken language. People were able to make decisions about their care and staff listened and respected their choices. Staff had the time to provide support in a compassionate and understanding way. People’s dignity was maintained, their privacy respected, and their independence promoted. The support people received enabled them to maintain relationships that were important to them.

People contributed to the planning and review of their care. They received support that was individual and their care records were personal to them. When needed, people’s care records were adapted to make them easier for people to understand. People knew how to raise concerns or complaints. They were confident to do this, and the provider took timely action to deal with any issues. The provider expected staff to have a caring and non-discriminatory approach to people who used the service and their colleagues.

There was a registered manager in post who understood their responsibilities. The service was we

This inspection was announced and took place on 17, 18 and 21 November 2016. This was the first inspection of the service since the provider registered with us in July 2013. Helping Angels is registered to provide personal care support to people living in their own homes in Stoke on Trent and the surrounding areas. People who used the service were older people with physical health needs (some of whom were living with dementia), and younger adults and children with disabilities. At the time of our inspection, 56 people were receiving personal care support.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff gained people’s consent before they were supported. However, when people were unable to make decisions about their care, the provider had not assessed their capacity, and was not able to show how decisions made on behalf of these people were in their best interests.

Some people needed greater continuity in the support they received, and staff did not always have the information required to provide individualised support to people. The provider did not actively encourage people to share their experiences and some people were not confident to report concerns.

People were kept safe by staff who knew how to safeguard people and protect them from harm. Staff understood how to recognise possible abuse and were confident to report any concerns. Risks associated with people’s care were assessed and staff knew how to support people to minimise any risks. There were enough staff to meet people’s needs and the provider had recruitment processes to check staffs suitability to work with people. Medicines were managed to reduce any risks associated with them.

Staff had the knowledge to provide effective care to people, and they received training to develop their skills. People were able to make choices about the food they ate and were supported to maintain their health and wellbeing. People were involved with the assessment and planning of their care, and the provider was responsive to people’s changing needs.

Staff supported people in a kind a caring manner and people had developed positive relationships with them. People were involved in making decisions about their day-to-day care, and staff promoted their independence. People were treated in a dignified manner and their privacy was respected.

The service was well managed and the provider had systems in place that identified areas where improvements were required. There were quality checks in place and these were used to drive continuous improvement. Staff felt supported and valued in their roles and the registered manager understood their responsibilities.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.